Form Sc1041 - Fiduciary Income Tax Return - 2005 Page 4
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4TAX WITHHELD FOR NONRESIDENT BENEFICIARIES
(Rev. 8/28/03)
Under South Carolina law the executor, administrator or other fiduciary of an estate or trust is required to withhold 7% of the amount of South
Carolina taxable income distributable to each nonresident beneficiary. The amount withheld from each beneficiary will be reflected on column F,
Part IV, page 3 of SC1041. For each beneficiary from whom an amount is withheld, a report "Fiduciary Report of Nonresident Beneficiary Tax
Withheld" (Form SC41) must be prepared. Be sure to insert current year in space provided. Form SC41 is to be distributed in the following
manner:
Copy - to the beneficiary from whom the tax is withheld so that the beneficiary may attach it to his South Carolina income tax return.
Copy - to the beneficiary for his records.
Copy - to be retained by the fiduciary.
The amount of tax withheld by the fiduciary should be claimed as SOUTH CAROLINA INCOME TAX WITHHELD on the SC Income Tax
Return.
Note: Any estimated income tax payments assigned to beneficiaries must be reported to them on Form SC41, along with instructions
to enter this amount as tax withheld on their South Carolina income tax return. Form SC41 must be attached to the beneficiary's
return to claim this payment.
Social Security Privacy Act Disclosure
It is mandatory that you provide your social security number on this tax form if you are an individual. 42 U.S.C 405(c)(2)(C)(i) permits a state to use an
individual's social security number as means of identification in administration of any tax. SC Regulation 117-201 mandates that any person required to
make a return to the SC Department of Revenue shall provide identifying numbers, as prescribed, for securing proper identification. Your social security
number is used for identification purposes.
STATE OF SOUTH CAROLINA - INCOME TAX
20
SC41
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEI NO.
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$
STATE OF SOUTH CAROLINA - INCOME TAX
20
SC41
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEI NO.
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$
STATE OF SOUTH CAROLINA - INCOME TAX
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
20
SC41
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEI NO.
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$
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